The Truth Behind the Most Common Medicare Myths

Do you want to know the truth about Medicare? It can be a tricky process. And because of that, several Medicare myths can cause you to make some serious mistakes with your coverage. Here’s a list of the common questions we hear and what you need to know to help with this process.

Medicare Part B is not required by law. If you’re new to Medicare, Part B can seem like it’s mandatory. However, if you choose not to enroll in Part B without maintaining creditable coverage, there are penalties associated with delayed enrollment. If you’re still working at 65 and have insurance through your job, you can delay your Part B enrollment.

Medicare is only available to U.S. citizens and legal residents. Still, a birth certificate is not required to apply for Medicare. If you don’t have a birth certificate, you must provide two official pieces of documentation, e.g., a medical or census record or an insurance policy.

No. The Social Security Administration (SSA) administers Original Medicare (Parts A and B) as a federal option. However, private insurance carriers provide Medicare plans, including:

• Medicare Advantage (Part C)
• Medicare Part D
• Medicare Supplement Insurance (Medigap)

Moving can significantly impact your Medicare coverage, particularly for Medicare Advantage or Medicare Prescription Drug Plan (Part D). Here’s how:

• Medicare Advantage: Your rate and plan were determined mostly by the area you live in and the providers you can visit. Moving, unless it’s nearby, can cause your MA plan to change completely, both in the doctors you see and the rates you pay.
• Part D: Medicare’s drug plans classify prescription drugs into different lists and tiers, called formularies. A carrier’s formulary in one state may vary from its formulary in another. You may pay more, or less, for your prescriptions if you move to another state.

Some people may get enrolled automatically, but you should always contact Medicare to be sure. The confusion stems from the fact that some people may be automatically enrolled in Medicare Part A when they turn 65, but this typically only happens if they’re already drawing social security benefits.

Medicare Parts A and B offer excellent coverage and will take care of many of your hospital and medical bills. It rarely provides everything a patient needs, however. Instead, you’ll want to factor in additional costs for the following services:

• Prescription drugs
• Dental
• Vision
• Hearing
• Long-term care

You can. Until recently, patients with ESRD couldn’t sign up for Medicare Advantage. This change means that ESRD patients can take advantage of the out-of-pocket maximums that many Medicare Advantage Part C plans offer while still paying the same prices for the critical services they need.

No, it’s not, but there’s a good chance you’ll receive at least a portion of your coverage at no charge. If you worked at least 10 years, you’re probably eligible for no-cost Medicare Part A coverage.

Part B and Part D both have a monthly premium. Most Medicare Advantage plans bundle Part A, Part B, Part D, and provide options that Original Medicare doesn’t.

No; Part A and Part B are different policies. Part A covers hospital bills and is usually available at no cost if you worked 10 or more years. If you worked less than 10 years, you may have a Part A monthly premium. Part B, also known as medical coverage, is income-based and comes with its own monthly payment — no matter how long you worked.

Maybe, but this depends on whether you retire after you’ve turned 65 — the age you become eligible for Medicare. And unless you had other creditable coverage until then, delaying your Medicare enrollment can bring some stiff penalties.

No. Obamacare, or The Affordable Care Act (ACA), made it illegal for insurance companies to deny coverage because of a pre-existing condition. This includes Medicare. As long as you’re 65 or older, and a legal U.S. citizen, you can’t be denied Medicare coverage because you’re in poor health.

No — enrollment actually goes through the Social Security Administration (SSA). The SSA handles all your paperwork. That includes enrollment. The SSA also distributes your benefits and handles your payments, including your monthly premium.

No. Many Medicare enrollees think a good Medicare Supplement (Medigap) plan will provide the same benefits as Medicare Advantage, but Medicare Supplement plan plans are designed to work alongside traditional Medicare. Medigap plans typically cover costs over and above what Parts A and B cover — they don’t replace them.

Medicare Advantage, on the other hand, is a popular choice because it often combines your Parts A and B and usually includes a prescription drug plan, while Medigap plans do not.

No, Medicare and Medicaid are two separate programs. Medicare is government-sponsored health insurance that’s available to all Americans aged 65 and older. Medicaid is a state and federal program that assists individuals and families with low and limited incomes. The two do work together when a patient has been deemed dual-eligible.